title: Dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) for differential diagnosis in head and neck cancers.
abstract: OBJECTIVE
  To examine the potential of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) for differential diagnosis of head and neck cancer.
  
  
  METHODS
  DCE-MRI was performed in 26 patients with untreated squamous cell carcinoma (SCC), 28 undifferentiated carcinoma (UD) and 8 lymphoma. DCE-MRI was analyzed with the pharmacokinetic model proposed by Tofts and Kermode to produce the three DCE parameters: k(trans), v(e) and v(p). Areas under the curve (AUC) at the initial 60 and 90s (AUC60 and AUC90) were also recorded. Histogram analysis was conducted to obtain the mean, 25%, 50%, 75% and 95% percentile values and the Kruskal-Wallis test was used to compare the DCE parameters between the three groups of cancer.
  
  
  RESULTS
  k(trans), AUC60 and AUC90 showed significant differences (p<0.01) between UD/SCC and UD/lymphoma, but not between SCC/lymphoma. The mean AUC90 demonstrated the highest accuracy of 78% (sensitivity of 68% and specificity of 88%) for distinguishing UD and SCC, and the 75% percentile AUC90 provided the highest accuracy of 97% (sensitivity of 100% and specificity of 88.5%) for distinguishing UD and lymphoma.
  
  
  CONCLUSIONS
  There are significant differences in the DCE parameters which show the potential for distinguishing UD from SCC or lymphoma.
authors.affiliation: Department of Imaging and Interventional Radiology, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong SAR. leekarhof@hotmail.com
authors.forename: Francis Kar-Ho
authors.initials: FK
authors.lastname: Lee
authors.forename: Ann Dorothy
authors.initials: AD
authors.lastname: King
authors.forename: Brigitte Buig-Yue
authors.initials: BB
authors.lastname: Ma
authors.forename: David Ka-Wai
authors.initials: DK
authors.lastname: Yeung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008223:Lymphoma / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media